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Female Sexual Dysfunction
Provoked Vestibulodynia
Provoked vestibulodynia is characterized by severe, sharp pain localized to the vulvar vestibule specifically triggered by pressure such as intercourse, tampon insertion, or gynecologic exam, without spontaneous pain.
75%
Success Rate
3-6 months with conservative treatment; surgical recovery 6-8 weeks
Duration
Multiple
Treatment Options
3+ Groups
May Affect
What is Provoked Vestibulodynia?
Provoked vestibulodynia is characterized by severe, sharp pain localized to the vulvar vestibule specifically triggered by pressure such as intercourse, tampon insertion, or gynecologic exam, without spontaneous pain.
Prevalence: Most common cause of superficial dyspareunia in premenopausal women
Symptoms and Signs
- •Sharp entry pain with intercourse
- •Pain with tampon insertion
- •Pain during gynecologic exam
- •No pain when area is not touched
- •Normal sexual desire and arousal
- •Relationship strain from sexual avoidance
Causes and Risk Factors
Common Causes
- →Nerve proliferation and hypersensitivity
- →Chronic inflammation of vestibular glands
- →Pelvic floor muscle hypertonicity
- →Hormonal factors (oral contraceptive use)
- →Genetic predisposition
Risk Factors
- ⚠️Early oral contraceptive use
- ⚠️Recurrent yeast infections
- ⚠️Pelvic floor tension
- ⚠️Young age at symptom onset
Treatment Options
Expected Outcomes: 70-85% improvement with vestibulectomy; 50-70% with conservative therapy
Available Treatments:
- ✓Pelvic floor physical therapy
- ✓Topical lidocaine
- ✓Cognitive behavioral therapy
- ✓Vestibulectomy surgery
- ✓Biofeedback therapy
- ✓Trigger point injections
- ✓Low-dose tricyclic antidepressants
Prevention Tips
- →Consider non-hormonal contraception
- →Pelvic floor relaxation
- →Avoid irritants
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